The Biomedical Mythology

by Bill Pearson

In this exercise we will review a paper in order to understand the assumptions that shape the biomedical story.

It is broadly assumed patient care is about science and the Hippocratic tradition. People go to med school because they “are good in science and want to help people”.

There is a growing movement within medicine to include spirituality. This kind of change provides an opportunity to sound out an explanatory model.

As it turns out, there is more to the story…

Disclaimer

• This presentation is not a critique of Drs. Post, Puchalski, and Larson. • It is an evaluation of the Biomedical Mythology imbedded in their paper.• I understand this paper to represent a mainstream of thought in reference

to spirituality and patient care. This paper is peer reviewed by medical professionals. It was not written to be theologically correct. Whether the authors would have presently the information differently if writing a theological paper is speculative and beside the point.

• What this paper does is provides an excellent opportunity to see how the biomedical story shapes the “truth” the medical profession professes. I think this is an especially helpful exercise because it is an issue sympathetic to the Christian faith and was written by people of faith. If we take issue with this paper theologically, then perhaps we should question the entire enterprise.

Instructions

• In this exercise we will read an excerpt and try to understand the values behind these statements. The blue stars indicate statements that merit particular attention

• The key question we are asking is:

What is the Biomedical Mythology?

The authority to deal with death and disease is through scientifically validated interventions. Nothing else, even if it does exist, can be known (fact-value dichotomy). We attend the spiritual interest of patients to bring them to the truth of scientifically valid interventions.

Modern:

(Do we reverse this false dichotomy and use health care as a tool to bring people to Jesus?)

Utilitarian:Spirituality is a good because it effects positive health outcomes. Health is our ultimate good. Everything serves this end. It functions as our national religion. It receives a tithe of 14% of our GNP. (We give .1% to international health and development.)

(Who then are the Pharisees of American Culture?)

Pragmatism:

There is no truth without data (approximated certainty). If it works we can measure it. If we can measure it, then it counts.

(Is God’s reality the only spiritual reality that can produce measurable results?)

Hippocratic Ideal:

Providers are to do whatever is in the best interest of the patient…

Lockean Ideals:

The right to life, liberty and the pursuit of happiness. Individual patient autonomy trumps everything. You must respect the beliefs of your patient.

(We can respect autonomy without having to respect the belief system. As a profession there are times we disrespect autonomy, i.e. suicide)

Pluralism:

Privatized religious or value claims are to be understood within the patients explanatory model (but not the biomedical model). Spirituality is a good, as long as it is in the image of medicine (sterile, impersonal, dichotomized, scientifically validated, economically feasible).

Market Driven:

The almighty dollar shapes medical practice and therefore ethics. We define what we do as the market share instructs us to do so.

(Oz is unveiled. Is the dollar the “divine presence”?)

In order to speak the whole truth, one must always say two things; in which God one believes and in which idol one does not believe, Without such a dialectic formulation, faith remains too abstract, it is likely to be empty and, what is worse, can be very dangerous, because it may very well allow for the coexistence of belief and idolatry.

Moreover, I have learned that to have faith in God means to do the will of God, to follow Jesus with the Spirit of Jesus in the cause of God's kingdom...”

Jon Sobrino. The Principle of Mercy. pg 9. Orbis Books. Maryknoll, NY 1992

bill_pearson@hms.harvard.edu